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Found 9062 cases where Vaccine is PNC13

Case Details (Reverse Sorted by Appearance Date)

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VAERS ID:507498 (history)  Vaccinated:2013-09-30
Age:0.3  Onset:2013-10-05, Days after vaccination: 5
Gender:Female  Submitted:2013-10-14, Days after onset: 9
Location:Ohio  Entered:2013-10-17, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: WBC 15.2; Hgb 11.1; HCT 34.3; Plt 468; KUB; Abd. ultrasound confirmed intussusception
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B421AA1IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH826AA1IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG047741IMRL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41CB346A1PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Enema administration, Grunting, Haematochezia, Haematocrit decreased, Haemoglobin normal, Intussusception, Platelet count normal, Ultrasound abdomen abnormal, Urinary system X-ray, Vomiting, White blood cell count normal
SMQs:, Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)
Write-up: 10/5/13 ER with vomiting and grunting, pulling up legs. Abd. films negative - discharged home. 10/7/13 Presented to ER with vomiting and bloody stool. 10/7/13 - Dx: ileocolic intussusception. Tx: air enema.

VAERS ID:507533 (history)  Vaccinated:2013-10-11
Age:1.2  Onset:2013-10-11, Days after vaccination: 0
Gender:Male  Submitted:2013-10-14, Days after onset: 3
Location:Michigan  Entered:2013-10-17, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0384AE0IMRL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB703AA0IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0146470SCRA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG665380IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0184600SCLA
Administered by: Private     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:507550 (history)  Vaccinated:2013-08-02
Age:0.4  Onset:2013-08-13, Days after vaccination: 11
Gender:Male  Submitted:2013-10-17, Days after onset: 65
Location:Indiana  Entered:2013-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALS749CT1UNLG
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.H0205991UNLG
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG665401UNLG
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0285AE1UNLG
Administered by: Unknown     Purchased by: Public
Symptoms: Crying, Diarrhoea, Haematochezia, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (narrow)
Write-up: Fever following rotavirus injection. Ongoing crying for several days. 11 days later diarrhea (over 15 diapers in 24 hours) with blood in stool.

VAERS ID:507553 (history)  Vaccinated:2012-04-25
Age:0.2  Onset:2012-05-04, Days after vaccination: 9
Gender:Male  Submitted:2013-10-17, Days after onset: 531
Location:Illinois  Entered:2013-10-17
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Blood work, chromosomal work, eye and ear tests, genetic testing
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B323AA0UNUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF803820UNUN
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1671AA0UNUN
Administered by: Unknown     Purchased by: Private
Symptoms: Acoustic stimulation tests, Autism, Blood test, Chromosomal analysis, Cytogenetic analysis, Developmental delay, Epilepsy, Grand mal convulsion, Ophthalmological examination
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Full Tonic Clonic Seizure, epilepsy, global developmental and physical delays, Autistic symptoms/tendencies.

VAERS ID:507559 (history)  Vaccinated:2013-10-15
Age:0.7  Onset:2013-10-15, Days after vaccination: 0
Gender:Female  Submitted:2013-10-17, Days after onset: 2
Location:Tennessee  Entered:2013-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSBC755 IMRL
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC44B5AA IMRL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4692CA IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG49716 IMLL
Administered by: Public     Purchased by: Public
Symptoms: Incorrect dose administered
SMQs:
Write-up: Nurse administered Pediarix (DTaP, IPV and Hepatitis B) and Pentacel (DTaP, IPV and HIB) on the same visit. Child received 2 doses of DTaP and IPV at one visit.

VAERS ID:507727 (history)  Vaccinated:2013-08-14
Age:0.4  Onset:2013-10-07, Days after vaccination: 54
Gender:Male  Submitted:2013-10-17, Days after onset: 10
Location:California  Entered:2013-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Xray abdomen; US abdomen
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4431AA1IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH833AA1IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURJ14061IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHH006721IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.H0205601PO 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal X-ray, Intussusception, Therapeutic procedure, Ultrasound abdomen
SMQs:, Gastrointestinal obstruction (narrow)
Write-up: Intussusception 7 weeks 5 days after ROTATEQ #2. Intussusception successfully reduced in radiology.

VAERS ID:508449 (history)  Vaccinated:2010-01-04
Age:0.3  Onset:2011-01-01, Days after vaccination: 362
Gender:Female  Submitted:2013-10-15, Days after onset: 1017
Location:Foreign  Entered:2013-10-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Human closed patch testing (unknown date): allergy for aluminumchloridehexahydrate
CDC 'Split Type': 2013291393
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPIPV: DTP + IPV (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH 0UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Allergy to metals, Injection site granuloma, Skin test positive
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: This is a spontaneous report from a contactable physician. This is a report received from the Agency. Regulatory authority report number DK-DKMA-ADR 21939845. A 2-year-old female patient received first dose of PREVENAR 13, via an unspecified route of administration on 04Jan2010 at single dose and first dose of DI-TE-KI-POL, via an unspecified route of administration at single dose. The patient subsequently received the second dose of PREVENAR 13 on 25Feb2013 and the third dose on 06Oct02013 both via an unspecified route of administration. In addition the patient received second dose of DI-TE-KI-POL on 25Feb2010 and third dose on 06Oct2010 via an unspecified route of administration. On 12Jan2011 the patient was vaccinated with PRIORIX. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient experienced aluminum granuloma after vaccination (injection site granuloma) (medically significant) on Jan2011 and allergy to aluminum (allergy to metals) (medically significant) on Jan2011. Lab data included human closed patch testing on an unknown date which showed allergy for aluminumchloridehexahydrate. Outcome of the reported events was not recovered.

VAERS ID:508454 (history)  Vaccinated:0000-00-00
Age:  Onset:0000-00-00
Gender:Unknown  Submitted:2013-10-15
Location:Foreign  Entered:2013-10-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Body temperature, 40 Centigrade
CDC 'Split Type': 2013291587
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Paralysis
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: This is a spontaneous report from the non-clinical study program, from a non-contactable consumer. A patient of unspecified age and gender received a single dose of PREVENAR 13, via an unspecified route of administration, on an unknown date. Medical history and concomitant medications were not reported. On an unknown date, the patient had paralysis, got that 40 Celsius degree and became disabled for a whole life. The outcome of paralysis and got that 40 Celsius degree was unknown. No follow-up attempts possible. No further information expected.

VAERS ID:508557 (history)  Vaccinated:2013-09-10
Age:0.2  Onset:2013-09-13, Days after vaccination: 3
Gender:Male  Submitted:2013-10-17, Days after onset: 34
Location:Foreign  Entered:2013-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Coagulation test normal, Sep2013, normal; Platelet count normal, Sep2013, normal
CDC 'Split Type': D0081418A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (FOREIGN)GLAXOSMITHKLINE BIOLOGICALSA20CA960B IMLG
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG79393 UNUN
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSAROLA497A PO 
Administered by: Other     Purchased by: Other
Symptoms: Coagulation test normal, Petechiae, Platelet count normal, Skin haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: This case was reported by a physician via a foreign regulatory authority (# DE-PEI-PEI2013056611) and described the occurrence of possible vasculitis in a 10-week-old male subject who was vaccinated with INFANRIX-IPV+Hib (GlaxoSmithKline) and ROTARIX (GlaxoSmithKline). Co-suspect vaccinations included (non-GSK) PREVENAR 13 (Pfizer Pharma). Concomitant medication was not reported. On 10 September 2013 the subject received an unspecified dose of INFANRIX-IPV+Hib (0.5 ml, intramuscular, unknown thigh), an unspecified dose of ROTARIX (1.5 ml, oral) and an unspecified dose of PREVENAR 13 (0.5 ml, unknown). Approximately three days post vaccination with INFANRIX-IPV+Hib, ROTARIX and PREVENAR 13, on 13 September 2013, the subject experienced possible vasculitis with petechiae and skin bleeding on both legs. This case was assessed as medically serious by GSK criteria. Coagulation test was normal. The subject did not experience thrombocytopenia. The subject showed no signs of infection. On the next day, on 13 September 2013, the events were already improving. At the time of reporting, on 26 September 2013, the final outcome of the events was not specific. No further information will be available.

VAERS ID:507330 (history)  Vaccinated:2013-10-14
Age:0.5  Onset:2013-10-15, Days after vaccination: 1
Gender:Male  Submitted:2013-10-16, Days after onset: 1
Location:Florida  Entered:2013-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness no rashes
Preexisting Conditions: Eczema
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4383CA0IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.H0145130IMLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURJ12810IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG548981IMLA
Administered by: Private     Purchased by: Public
Symptoms: Crying, Rash, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow)
Write-up: Had event of uncontrollable "shaking" then broke out in rash, was crying inconsolable.

VAERS ID:507364 (history)  Vaccinated:2013-09-18
Age:1.1  Onset:2013-09-30, Days after vaccination: 12
Gender:Male  Submitted:2013-10-09, Days after onset: 9
Location:Alabama  Entered:2013-10-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Otitis media; Allergic rhinitis
Preexisting Conditions: Otitis media; Bronchitis; Allergic rhinitis; Hand foot mouth
Diagnostic Lab Data: Normal MRI - on 10/2/13
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG940593IMRL
Administered by: Private     Purchased by: Private
Symptoms: Eye movement disorder, Nerve injury, Nuclear magnetic resonance imaging normal, Strabismus
SMQs:, Accidents and injuries (narrow), Ocular motility disorders (narrow)
Write-up: Abnormal eye movements noticed by mother of patient on 9-30-13 - was seen in ER. MRI was normal. 6th cranial nerve damage (strabismus) - normal MRI, referred to ophthalmologist.

VAERS ID:507367 (history)  Vaccinated:2013-06-13
Age:0.4  Onset:2013-07-13, Days after vaccination: 30
Gender:Female  Submitted:2013-10-09, Days after onset: 88
Location:California  Entered:2013-10-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: MRI; EEG and blood work
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B408BA1UNUN
HIBV: HIB (ACTHIB)SANOFI PASTEURUH737AB1UNUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG319391UNUN
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FB350A1UNUN
Administered by: Private     Purchased by: Other
Symptoms: Blood test, Convulsion, Dyskinesia, Electroencephalogram, General physical condition abnormal, Infantile spasms, Nuclear magnetic resonance imaging, Posture abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (narrow), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Neonatal disorders (narrow), Generalised convulsive seizures following immunisation (narrow)
Write-up: She was diagnosed with infantile spasms which I believe was caused by the DTAP vaccine. My daughter began dropping her head and I noticed a dazed look on her face. I then realized that she was having a seizure, when the jackknife movements began to last 10 minutes or less. She is currently on her 3rd treatment ACTHAR injections.

VAERS ID:507396 (history)  Vaccinated:2013-09-20
Age:0.2  Onset:2013-09-20, Days after vaccination: 0
Gender:Female  Submitted:2013-10-16, Days after onset: 26
Location:Connecticut  Entered:2013-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: N/A
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG54898 UNUN
Administered by: Private     Purchased by: Other
Symptoms: Decreased eye contact
SMQs:
Write-up: Baby stopped making eye contact soon after receiving the shot and was unable to make eye contact for a full three days after the vaccination.

VAERS ID:507907 (history)  Vaccinated:2013-10-07
Age:71.0  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:Oregon  Entered:2013-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH906AA1UNLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG571960UNRA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0016920UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Vomiting.

VAERS ID:507978 (history)  Vaccinated:2013-10-09
Age:0.5  Onset:0000-00-00
Gender:Male  Submitted:2013-10-10
Location:Georga  Entered:2013-10-16, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSJP2HP0UNRL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4779AA0UNRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH681AA2UNLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG057871UNLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.J0050732PO 
Administered by: Private     Purchased by: Private
Symptoms: Wrong drug administered
SMQs:
Write-up: KINRIX (Dtap and Polio) given instead of separate Dtap and Polio (IPV) vaccines.

VAERS ID:507266 (history)  Vaccinated:2013-09-30
Age:59.0  Onset:2013-10-01, Days after vaccination: 1
Gender:Female  Submitted:2013-10-15, Days after onset: 14
Location:Florida  Entered:2013-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHH07344 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Blister, Injection site vesicles
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: Blisters around the injection site and down the arm.

VAERS ID:507881 (history)  Vaccinated:2013-10-04
Age:4.0  Onset:2013-10-05, Days after vaccination: 1
Gender:Male  Submitted:2013-10-15, Days after onset: 10
Location:Alaska  Entered:2013-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B204AA4UNRL
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.BH2090 IN 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0097821UNLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF264810UNRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H001701UNLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen right thigh from knee-up. Started about 24 hours after immunizations on 10/4/13, resolved around 10/9/13. No treatment. Provider (PMD) notified.

VAERS ID:508144 (history)  Vaccinated:2013-07-16
Age:0.2  Onset:2013-07-16, Days after vaccination: 0
Gender:Male  Submitted:2013-10-15, Days after onset: 91
Location:Ohio  Entered:2013-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALS749CT0IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUA735AC0IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG474230IMLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41CB344A0PO 
Administered by: Public     Purchased by: Other
Symptoms: Crying
SMQs:, Depression (excl suicide and self injury) (broad)
Write-up: Cried for couple hours the first day of vaccines.

VAERS ID:508149 (history)  Vaccinated:2013-08-22
Age:0.2  Onset:2013-08-22, Days after vaccination: 0
Gender:Male  Submitted:2013-10-15, Days after onset: 54
Location:Maryland  Entered:2013-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC4486AA UNLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHH00672 UNRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left leg swelled very badly. Lasted for 24 hrs, 8 hrs at its worse.

VAERS ID:508155 (history)  Vaccinated:2013-08-05
Age:0.5  Onset:2013-08-06, Days after vaccination: 1
Gender:Female  Submitted:2013-08-12, Days after onset: 6
Location:California  Entered:2013-10-15, Days after submission: 64
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC4483AA2UNRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.H0170182UNLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG961572UNLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.J0043942PO 
Administered by: Private     Purchased by: Private
Symptoms: Crying, Poor quality sleep, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Depression (excl suicide and self injury) (broad)
Write-up: Poor sleep 8/5/13 night. On 8/6/13 patient had more than 3 hrs of inconsolable crying, and fever. Seen at ER 8/6/13 evening. Parents declined work up for fever, (CXR and Cath urine). Patient was seen at our office 8/7/13, no fever or fussiness, better. Injection site NL. 8/8/13 no fever, not fussy, back to normal self.

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